POS0993-HPR NAILFOLD VIDEOCAPILLAROSCOPIC CHANGES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PSORIATIC ARTHROPATHY ON ANTI-TNF-ALPHA THERAPY
Authors: D. Anghel, O. G. Petrache, D. Opris-Belinski, V. Bojinca, L. Groseanu, M. M. Negru, A. Mihai, C. F. Pleșa, F. Ioniță-Radu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> It is known that systemic inflammation in rheumatic diseases was associated with microvascular involvement that can determine the severity and prognosis of the disease [1]. Videocapillaroscopy is an easy and non-invasive method with high sensitivity and specificity, that allows the study "in vivo" of nailfold capillaries. <h3>Objectives</h3> To assess the changes in capillary morphology in rheumatoid arthritis and psoriatic arthritis patients after anti-TNF-alpha treatment using nailfold videocapillaroscopy. <h3>Methods</h3> We performed a retrospective study on 80 patients (rheumatoid arthritis (RA) – 30 patients, psoriatic arthritis (PsA) – 31 patients and a control lot – 19 healthy subjects). Inclusion criteria: patients with high disease activity with RA (who met the EULAR/ACR 2010 criteria), and patients with PsA (who met CASPAR criteria). Exclusion criteria: age under 18 years old, Raynaud's syndrome, history of smoking or alcoholism, patients with history of biological treatment. Patients received anti-TNF-alpha therapy (Infliximab – 33.3% of RA patients and 25.8% PsA patients, Adalimumab - 36.7 % of RA patients and 38.7% of PsA patients, Etanercept- 33.3% of RA patients and 35.5% of PsA patients). In the RA group, 86% of the patients were females, and the mean age of the group was 42 ± 12. In the PsA group, 57% of the patients were females and the mean age of the group was 46 ± 19. We used a videocapillaroscope (VideoCap 3.0) with a magnification of 200x before (T0) and after 6 months of anti-TNF-alpha treatment (T1). We analyzed the capillaroscopic abnormalities such as bushy, tortuous capillaries, dilated capillaries, megacapillaries, hemorrhages, angiogenesis and avascular areas. <h3>Results</h3> We observed a significant correlation between the use of anti-TNF agents and improved. capillary density in RA patients (p=0.00001) and PsA patients (p=0.00002). Moreover, significant correlation was observed between the improvement of avascular areas and Adalimumab use in both groups (p=0.001). We also observed a significant correlation between the lack of angiogenesis and six months use of anti-TNF agents in RA group (p=0.00001) and PsA group (0.00003). A significant correlation was observed between the use of Infliximab and the lack of dilated capillaries (p=0.00005) in the RA group and the use of Etanercept (p=0.00001) and Infliximab (p=0.00001) in the PsA group. Also, strong correlation was observed between the lack of giant capillaries at 6 months and the use of TNF-alpha inhibitors in RA group (p=0.00003) and PsA group (p=0.00001). Significant correlation was found between the lack of hemorrhages and the use of 6 months of Adalimumab and Etanercept in the RA (p=0.00003) and the use of Adalimumab, Etanercept and Infliximab in the PsA (p=0.00001). No significant correlations were observed between videocapillaroscopic changes and age and sex. Also, no significant correlations were observed between the use of TNF-alpha inhibitors and elongated, tortuous and ramified capillaries in both groups. <h3>Conclusion</h3> According to our findings, after six months of anti-TNF treatment we observed a decrease in the incidence of dilated/giant capillaries, angiogenesis, hemorrhages and avascular areas in RA and PsA patients. Nailfold capillaroscopy could be useful in monitoring the efficacity of the biological treatment in patients with inflammatory arthritis. <h3>Reference</h3> [1]Cutolo M, Sulli A, Secchi ME, Paolino S, Pizzorni C. Nailfold capillaroscopy is useful for the diagnosis and follow-up of autoimmune rheumatic diseases. A future tool for the analysis of microvascular heart involvement? Rheumatology (Oxford). 2006 Oct;45 Suppl 4:iv43-6. doi: 10.1093/rheumatology/kel310. PMID: 16980724. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.